Miss. Dems seek new approach on Medicaid expansion

JACKSON -- Democrats in the Mississippi Legislature say they're trying a new approach to push for Medicaid expansion -- an issue they support and Republican leaders oppose.

Democrats hold a minority of seats in the House and Senate and they've pushed unsuccessfully this legislative session to bring up Medicaid expansion for debate in either chamber. They sent Republican Gov. Phil Bryant a letter Wednesday, saying they want to file a bill specifying that the state will expand Medicaid only if the federal government cuts "disproportionate share" payments to hospitals.

The payments are compensation for treating uninsured patients, and hospital executives fear millions of dollars will disappear.

"Without disproportionate share payments, many rural hospitals and hospitals that treat a disproportionate share of uninsured Mississippians will close," Sen. David Blount, D-Jackson, said during a news conference that two dozen Democrats had in the Capitol rotunda. "People will lose jobs and people will lose access to health care, particularly in our rural communities."

Bryant said in an interview a short time later that he doesn't believe the federal government will eliminate disproportionate share payments.

"We believe that they would be in violation of the United States Supreme Court decision, which said you can't punish a state for not expanding Medicaid. And they certainly would be punishing us by doing that. So, I don't think that ought to be a trigger," Bryant told reporters in an office next to the House chamber, where he'd been having closed-door meetings with Republican lawmakers.

The U.S. Supreme Court last summer upheld most of the federal health overhaul that President Barack Obama signed into law in 2010. However, justices said states have an option, not a mandate, to expand Medicaid to people making up to 138 percent of the federal poverty level, or about $15,000 a year. In Mississippi, the current cutoff is about $5,500 a year, though the state's Medicaid program does not cover many able-bodied adults within that income group.